Tuesday, November 22, 2005

More on the disruptive physician

Medscape General Medicine recently posted a provocative discussion on this topic, which I had blogged about November 5. There appears to be a burgeoning power struggle between hospital administrators (and their lawyers) and some rank and file physicians. It’s an unintended consequence of the Health Care Quality Improvement Act of 1986, which sought to protect hospital peer review. It provides immunities for hospitals in the peer review process, greatly enhancing their power to discipline physicians. Some physician groups are concerned that this has lead to abuses of peer review as hospitals, for a variety of reasons, increasingly seek to control doctors, setting increasingly narrow boundaries for behavior. A related development has been the emerging notion of the “disruptive physician.” Originally conceived with the good intention of addressing the genuine problems of incompetence and abusive physician behavior, the concept has come to be used as a pretext for stifling dissent, eliminating economic competition and abusing the peer review process.

This article and an accompanying editorial discuss the related issues of sham peer review and the abuse of the “disruptive physician” concept.

1 comment:

Anonymous
said...

You might be interested in reading "Abuse of the Disruptive Physician Clause" which was published in the Fall 2004 issue of the Journal of American Physicians and Surgeons - available at www.jpands.orgIf you search under the cumulative index on this journal website, you will find many other informative article on sham peer review.

About Me

Originally a traditional internist, I became a hospitalist in the early days of the “movement.” I'll be writing about clinical topics, mainly in hospital medicine. Occasionally politics and other stuff creep in. This content does not constitute medical advice (consult your physician) nor is it authoritative (check primary sources).